- / Application form

Photo

for education in Russian Federation at the expense of the Federal funds

of Russian Federation within the quota
.
, *,
To be completed in block letters in Russian and/or English language
Fields marked with * are obligatory for filling
* / Registration number*

, -* / Country where the

application is submitted*
/ Filled in by representative of Russian
Federation in foreign country

/ Filled in by an officer of Russian Ministry of

education and science

( ) / Line of arrival (source of application form)

_____________________________________________________________________________________

/ Filled in by representative of Russian Federation in foreign country

* / Place of visa receipt*

/ Country

/ City
/ Filled in by representative of Russian Federation in foreign country

1. , ( )* /
Family name, latin letters (according to passport)*

2. (), ( )* /
Name (names), latin letters (according to passport)*

3. , * /
Family name, Cyrillic Russian transcription*

4. (), * /
Name, Cyrillic Russian transcription*

/ Filled in by representative of Russian

Federation in foreign country

5. ( ), (
)* / Fathers name (if available), in Russian
Cyrillic transcription*

/ Filled in by representative of
Russian Federation in foreign country

6. ( )* /
Place of birth (according to passport)*
(, ) / (country, city)

/ Filled in by representative of Russian

Federation in foreign country

7. * / Date of birth*
() /(day-month-year)
9. * / Citizenship*

8. * / Sex*

/ Male

/ Female

10. / Compatriot

, / If you
have many citizenships, specify all

1)

____________________________

2)

____________________________

3)

____________________________

(
) /
I am a person without citizenship

/ Im a compatriot
1. , ,
, , , ,
. / Compatriot is a person born in the country or lived there before who has common language,
historical, cultural features either a descendant of those persons
2. ( - ) ,
. / Compatriot abroad is a citizen of the Russian
Federation living abroad
3. ,
, , , ,
, ,
, : /
Compatriot is also a person and/or his/her descent living abroad who belongs to nations living on historical territory of the Russian
Federation who made a choice for religion, culture and legislation of the Russian Federation including:

, , , ,
; / a person who had the USSR nationality and/or living in
countries-members of the USSR who got citizenship of one of these countries or became a person without citizenship;

() , , ,
,
. / a Russian Federation/USSR emigrant who had a citizenship and got foreign citizenship or became
a person without citizenship.

11. : / Permanent address:

11.1 / Country
11.2 /
Postcode

11.3 / /
Region / State / Location

11.4 / /
City

11.5 , , , , / Street, building, flat

12. * / e-mail*
14. * /
Passport No*

15. * / Date of issue*

() / (day-month-year)

13. ( )* / Mobile (cell) phone

number (with country code)*
16. * / Valid till*
() / (day-month-year)
, 1,5
/ The validity of the passport should not expire earlier than 1,5 years from the date
of commencement of visa validity

17. () (
, ,
)* / Level of education you have got (If
you do not apply for full term of study, and want to undergo a probation,
please choose the level of education obtained)*
,
/ Choose ONLY one point level that gives you a right to continue
studies in Russia

(, , ; 8-9
) / Secondary School Certificate (8-9 study years)
(, , ; 10-12
) / Higher Secondary School Certificate (10-12 study years)

18. /
, * /
Name of graduated educational organization or where you are supposed
to graduate*

19. /
, * / Location of
graduated educational organization or where you are supposed to
graduate*
19.1 / Country

19.2 / City

(
, ) / Vocational Secondary Certificate
(Vocational/Technical School)
/ Bachelor Degree
( 55,5 ) / 19.3 , , , / Street, building
Specialty Degree (Higher education 5-5,5 study years)
/ Master Degree
/ PhD
/ Residency training

20. / Graduating year

/ Postgraduate military course

- / Assistantship-traineeship

21. * / Mode of study*

/ Full-time
/ Extramural
22. , * / Level of education that you want to obtain in Russia*
22.2 (
22.1 / Choose ONLY one point
) / Probation (DO NOT specify if continuing
professional education)
/ Vocational secondary
education
,
,
/ Bachelor Degree
, , ( 10
/ Specialty Degree
) / I do not apply for full term of study, but I want to undergo a
/ Master Degree
short-term program as part of bachelor, specialist, master's, PhD
programs (up to 10 months)
/ PhD

/ Residency training
/ Postgraduate military course

/ Duration of the program:

- (
) / Assistantship-traineeship (specialties in the field of
culture and art)

__________ / months

/ Continuing
professional education

() / Name of the additional professional education
program
_________________________________________________________

/ Semester:

/ Autumn
/ Spring
/ Summer school
/ Educational year

/ Duration of study:
__________ / months
/
Semester:

/
/

/

Autumn
Educational year
Spring

23. (, ) ( )* / Educational program

(specialty, profession) DO NOT specify if continuing professional education*
() russia-edu.ru / You can use russia-edu.ru website to
find the code and the full name of the educational program
23.1 / Code
23.2 / Full name
24. ( , -, ) /
Topic of research (for PhD, assistantship-traineeship, residency training)
25. (, ), * / Educational organizations*
6 . 2 , . . -.
, , ,
Specify all 6 points by priority. Do not choose more than 2 educational organizations from one federal region, Moscow city and Saint-Petersburg city. If you mention
only 1 educational organization and this organization refused to admit you, you will be finally refused to study in the Russian Federation.

1) _____________________________________________________________________________________________________
2) _____________________________________________________________________________________________________
3) _____________________________________________________________________________________________________
4) _____________________________________________________________________________________________________
5) _____________________________________________________________________________________________________
6) _____________________________________________________________________________________________________

26. ( ) * / Languages (including native) *

Russian language

1)
2)
3)
4)

/
/
, /

,


Native
Fluent
Intermediate
Beginner
Do not speak
/
/
, /



,

Native
Fluent
Intermediate
Beginner
/
/
, /



,

Native
Fluent
Intermediate
Beginner
/
/
, /



,

Native
Fluent
Intermediate
Beginner

27. () / Necessity to study at the Foundation course (Preparatory Faculty)

() . 1 .
() .
I need to get admission to the Foundation course (Preparatory Faculty) for the study of Russian language. Period of study 1 year. In that case educational
organization is to be chosen by the Ministry of Education and Science of the Russian Federation
28. / Sport achievements
29.
/ Additional information about different
1) ________________________ ______________________ ___________
achievements

/ sport

2) ________________________
/ sport

3) ________________________
/ sport

/ achievement

/ year

______________________

___________

/ achievement

/ year

______________________

___________

/ achievement

/ year

30. ,
* / The type of qualification tests that you have
taken in your country to obtain the quota*

/ Interview
/ Competition
/ The competition portfolio
/ Testing
(
) / Out of competition (providing quotas for the special
achievements in training)

31. * / The place of

qualification tests passing*

/ Embassy of Russian
Federation
() / The Russian Centre
of Science and Culture
/ National
education authority
() / ther (specify)______________________

() / Other (specify)__________________________
32. : / I attach the following documents:
* / Passport copy*
/ (
, * / Education certificate copy*
, ) / Research paper in Russian or English
(
language (for PhD, assistantship-traineeship, residency training)
)* / Copy of medical
(
certificate of overall health condition (DO NOT attach if continuing
, -,
professional education)*
) / List of publications (for PhD, assistantship (
traineeship, residency training)
)* / Copies of HIV + AIDS
, /
certificates (DO NOT attach if continuing professional education)*
Copies of documents which confirm the compatriot status
,
(opy
(Copies of documents which confirm the knowledge of the Russian
of document with the results of the qualifying tests)
language)

33. / Additional information

27.07.2006 152- ,
, , ,
. () (-)
, , ,
. ,
, ./ According to the Federal law from 27/07/2006 No 152-FZ About personal data
I accept the processing in hardware of personal data provided in the application and documents attached for the purpose of realizing my right to obtain education in the Russian
Federation by budgetary appropriations of federal budget. I am informed and agree to provide my personal data noted in the application and documents attached to the Russian
educational organizations for admission decision. I agree with transborder transmitting of my personal data noted in the application and attached documents via Internet.
() , , ,
.
. / I am informed that according to the Russian Legislation I can be
required to make educational documents equivalence procedure. The equivalence procedure is to be realized in compliance with the determinate order on the Russian Federation
territory after admission confirmation letter of the Ministry of Education and Science of the Russian Federation.

/ Date

/ Signature

() / (day-month-year)

, /
Information representative of the Russian Federation in foreign country who verified the completeness and accuracy of this application form
/ Filled in by representative of Russian Federation in foreign country

/ Officers Position

/
Full name

/ Date
() /
(day-month-year)

/ Signature